Circular tummy tuck versus extended? (Photo)

I think you would do well with liposuction to your flanks and an extended tummy tuck. This would not flatten your buttock and would be safer.

Hello RideWhitinTheStorm. Thank you for your question regarding whether an extended tummy tuck or a circular tummy tuck is better for your goals.

Based on your concerns, if you do not want a smaller, lifted buttock, I recommend the extended tummy tuck. This procedure will address your stomach laxity, muscle weakness, and excess skin without affecting your buttocks. Additionally, you could consider liposuction of the flanks and fat transfer to the buttocks for more of an hourglass shape. This combination can provide the contour you desire while enhancing your buttock volume.

The tummy tuck will be effective in tightening your abdominal muscles and removing excess skin, giving you a flatter and more toned stomach. Given your goals and concerns, I don't think you need the 360 body lift, as it might impact your buttocks more than you prefer.

Good luck with your procedure, and I hope this helps to answer your question regarding the best tummy tuck option for you.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Hello and thank you for your question. From the pictures you have provided, i cannot determine if you have any striae (stretchmarks) present. There is a moderate/severe amount of excess skin and subcutaneous fat present diffusely throughout your trunk- from your abdomen into your flanks and extending into your back. This is asymmetric in distribution. There are skin folds across your lower abdomen extending to your mid flanks, and you also have multiple asymmetrically present throughout your mid back. Having had 4 kids, you most likely have some degree of diastasis (separation) of your rectus abdominis muscles located centrally in your abdomen (the "6 pack" muscles). Based on all this, you would benefit from an abdominoplasty (tummy tuck- includes muscle repair) and 360 liposuction and fat grafting to your buttocks (BBL) to best help improve your abdominal/trunk contour.
The difference between a "standard" and "extended" tummy tuck is just how far your incision extends to the side, and this is based on how much excess skin and fat needs to be removed to produce an aesthetic contour. They are essentially the same procedure- the goal is improved body contour at the expense of scars, so this is important to keep in mind throughout the process. In your case, the scar would extend around to your sides.
The reason I said abdominoplasty instead of circumferential belt lipectomy ("circular tummy tuck") is because the excess skin in your back is located more in your mid/upper back, not as much in your lower back.
Liposuction would definitely provide additional benefit for you, particularly to the contour of your flanks and back, and is necessary for the buttock fat grafting (BBL) portion of the procedure. Keep in mind that for you, given that you have excess skin on your mid/upper back which is not addressed with the 360 liposuction or the abdominoplasty procedures, and which will most likely become more noticeable and even appear deflated after liposuction, you would likely need another procedure to address your excess mid/upper back skin at some point in the future in order to further improve your overall trunk contour. This would most likely consist of a staged upper back lift- the incision can be hidden in your bra line. A benefit of staging these procedures, is you can do further revision liposuction at that time, to correct any asymmetries or to provide further improved contour overall.
With all that said, it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from any photos and descriptions provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon